Multiparametric MRI for the Diagnosis of Tumor Type in Patients Suspicious of Inner Gland Prostate Cancer
Urology Journal,
Vol. 16 No. 06 (2019),
24 December 2019
,
Page 552-557
https://doi.org/10.22037/uj.v16i06.4998
Abstract
Purpose: The current study aimed to evaluate multiparametric MRI for the diagnosis of type of tumor (benign or
malignant) in patients suspicious of inner gland prostate cancer.
Materials and Methods: This cross-sectional study was conducted on 44 consecutive patients with a clinical
impression of prostate cancer who were referred to the MRI department of Payambaran Hospital, Tehran, Iran
for confirmative diagnostic evaluation. Cases suspected of tumor relapse and those who previously underwent
treatment for prostate cancer were excluded. Multiparametric MRI was performed for every patient by using a 1.5
Tesla device with an integrated endorectal and pelvic-phased array coil. All patients subsequently underwent MRItransrectal
ultrasound fusion biopsy. The diagnostic value of each sequence was then investigated individually and
in combination with other techniques by comparing the results with histological findings from MRI–TRUS fusion
biopsy.
Results: Among the techniques, T2-weighted imaging (T2W) had the highest sensitivity and specificity while
dynamic contrast enhanced (DCE) technique had the least. Diffusion-weighted imaging (DWI) and magnetic resonance
spectroscopy (MRS) had a similar sensitivity and specificity and did not significantly differ from T2W.
Adding functional techniques to T2W did not improve diagnostic indices compared to T2W alone. Quantitative
evaluation of apparent diffusion coefficient (ADC), DWI, and MRS showed that all techniques were able to differentiate
between benign and malignant tumors. However, the quantitative combination of these sequences decreased
diagnostic performance.
Conclusion: T2W is the best technique for the diagnosis of type of tumor in terms of benignancy or malignancy
in patients suspicious of inner gland prostate cancer. Adding functional imaging measurements to T2W does not
improve its diagnostic value.
How to Cite
References
Pakzad R, Rafiemanesh H, Ghoncheh M, Sarmad A, Salehiniya H, Hosseini S, et al. Prostate Cancer in Iran: Trends in Incidence and Morphological and Epidemiological Characteristics. Asian Pacific journal of cancer prevention : APJCP. 2016;17(2):839-43.
Delongchamps NB, Rouanne M, Flam T, Beuvon F, Liberatore M, Zerbib M, et al. Multiparametric magnetic resonance imaging for the detection and localization of prostate cancer: combination of T2-weighted, dynamic contrast-enhanced and diffusion-weighted imaging. BJU international. 2011;107(9):1411-8.
Hoeks CM, Hambrock T, Yakar D, Hulsbergen-van de Kaa CA, Feuth T, Witjes JA, et al. Transition zone prostate cancer: detection and localization with 3-T multiparametric MR imaging. Radiology. 2013;266(1):207-17.
Haider MA, Yao X, Loblaw A, Finelli A. Evidence-based guideline recommendations on multiparametric magnetic resonance imaging in the diagnosis of prostate cancer: A Cancer Care Ontario clinical practice guideline. Canadian Urological Association journal = Journal de l'Association des urologues du Canada. 2017;11(1-2):E1-e7.
Li H, Sugimura K, Kaji Y, Kitamura Y, Fujii M, Hara I, et al. Conventional MRI capabilities in the diagnosis of prostate cancer in the transition zone. AJR American journal of roentgenology. 2006;186(3):729-42.
Puech P, Sufana-Iancu A, Renard B, Lemaitre L. Prostate MRI: can we do without DCE sequences in 2013? Diagnostic and interventional imaging. 2013;94(12):1299-311.
Chesnais AL, Niaf E, Bratan F, Mege-Lechevallier F, Roche S, Rabilloud M, et al. Differentiation of transitional zone prostate cancer from benign hyperplasia nodules: evaluation of discriminant criteria at multiparametric MRI. Clinical radiology. 2013;68(6):e323-30.
Schimmoller L, Quentin M, Arsov C, Hiester A, Buchbender C, Rabenalt R, et al. MR-sequences for prostate cancer diagnostics: validation based on the PI-RADS scoring system and targeted MR-guided in-bore biopsy. European radiology. 2014;24(10):2582-9.
Kim JH, Kim JK, Park BW, Kim N, Cho KS. Apparent diffusion coefficient: prostate cancer versus noncancerous tissue according to anatomical region. Journal of magnetic resonance imaging : JMRI. 2008;28(5):117.
- Abstract Viewed: 245 times
- pdf/4998 Downloaded: 129 times